Have you ever left work feeling exhausted after eight or 12 hours of reaching, bending, twisting, pushing, and pulling? After such a shift, my whole body would be screaming, "Calgon, take me away!" Then after a night's rest, and a few ibuprofen, I was ready to do it all over again. But what was my body telling me?

Little injuries add up

We repeat hundreds of movements during a shift: bending and twisting while using transfer devices, reaching and pulling across beds to assist patient positioning, even pushing heavy carts or stretchers. When we exhaust a muscle group and don't allow it to recover, microscopic tears occur to the soft tissue—the precursor to adhesions between muscle groups and their surrounding tissue. Over time, the accumulation of adhesions can restrict normal movement of the tissue it surrounds, causing stiffness, and decreased range of motion, flexibility, and balance. When the rest of your body overtaxes itself to compensate, your odds of injury increase.

To avert a back injury that can interrupt your career, you need to recognize risk factors and incorporate preventive measures, according to the Office of Environmental Health and Safety. The most frequent culprit? Lifting more weight than you can handle. The U.S. Occupational Safety and Health Administration recommends that manual lifting of residents be minimized in all cases and eliminated when feasible. But how can nurses truly avoid all workplace lifting?

The core—Not just abs!

Physical conditioning—particularly a daily stretching routine and strength training of the core muscles—can reduce the frequency and severity of back injuries. Think of your core muscles as your center of gravity. They surround and embrace your midsection like a girdle, supporting your spine and torso movements and providing a foundation for coordinating your limb motions.

All movements originate from the center of the body. If your extremity muscles are strong, but your core is weak, you won't produce the force needed for efficient, safe, motion. Strong core muscles improve posture, balance, and stability—and can reduce back and neck pain. (For a list of your core muscles, see http://www.rnweb.com/.) A weak core is inefficient and makes you vulnerable to injuries, particularly if you are overweight, have had a previous injury, or suffer poor posture or body mechanics.

There are several options for improving your core strength and flexibility. Yoga and Pilates classes offer good core workouts by using the body as its own form of resistance. Stretching and breathing techniques and performing slow controlled movements allow you to isolate and strengthen core muscles.

If taking a class is not your thing, there are a few simple exercises you can do anywhere that will engage and strengthen your core. Full descriptions of these motions are found on http://www.rnweb.com/, along with a list of tips for reducing your risk of workplace back injuries.

Build your core, spare your back

We often don't realize how weak our bodies are until it's too late. Accumulative trauma can make you vulnerable to that one chance motion that harms not only your back, but also your finances and quality of life. Many states are instituting legislation for safe-patient-lifting committees and no-lifting laws. Until then, you can help reduce your chances of such an injury by strengthening your core muscles.